*Update* AMA Resolution on Disclosure Based on Misdiagnosis of Current Policies

Update (8/12/15 at 10:30 am): Dr. Todd Sack, the lead author of the American Medical Association policy on chemical disclosure, responded this week via email to EID’s item below. The full email is posted at the end of this update, but we’d like to single out a few points Dr. Sack is making here, and then juxtapose those alongside the actual facts.

Sack Claim #1: “70% of fracking wells hid from FracFocus or other databases at least one chemical used. Why do you think these chemicals were hidden from our citizens? Most people understand that companies are hiding serious toxins that may be hazardous to human health.”

FACT: There’s no “hiding” of chemicals here. Here’s a chemical disclosure form that we just pulled down off the FracFocus website – literally just grabbed the first one that came up when we searched for “Pennsylvania.” Here, we see a report on a well that was completed up in Bradford Co., Pa. back in 2013. Notice all the information that this form provides – not only telling you what the specific ingredients are, but also indicating how they’re used, in what volumes, and in what concentrations.

But despite all the data and information contained on this form, it technically would be considered one of Dr. Sack’s “70 percent of fracking wells” that “hide” chemical information from the public. And why is that? Because at the very bottom of the sheet, in a box that lists out a handful of ingredients used in the job that are so benign, they don’t even have an MSDS assigned to them, one of the surfactants used has its CAS number protected. As researchers from the University of Colorado found recently, “The ‘surfactant’ chemicals found in samples of fracking fluid collected in five states were no more toxic than substances commonly found in homes.”

So, in plain English: although we know the surfactant isn’t considered a risk or hazard to human health or the environment (far from a “serious toxin,” whatever that is) because the company in question here doesn’t provide the molecular breakdown of it on the from, Dr. Sack considers the entire disclosure to be unacceptable – yet another example of industry “hiding” important information from the public. Of course, if you actually go to FracFocus and look around for a few minutes, you’ll see this is absolute baloney. But Dr. Sack’s hoping you just take his word for it.

Sack Claim #2: “Physicians need this information to care for their patients. The disclosures on FracFocus are made long after the contamination has occurred, too late to be of much value to physicians or the public. Proper protection of human health requires full disclosure of the names of chemicals before drilling begins so that water supplies can be tested both before and after fracking. This is common sense, not expensive, and is wise. Only a thoughtless or irresponsible industry would not support these simple measures; I know that you & your readers will agree. It is absolutely proper for physicians to draw attention to these facts.”

FACT: First, the EPA has said there have been no “widespread, systemic impacts to drinking water resources” from hydraulic fracturing. And in the rare cases where contamination (not from the fracking process itself but from activities associated with drilling) occurs, MSDS sheets are provided to the necessary parties.

Specifically, a physician treating a patient who believes development has impacted his or her health is immediately able to obtain the complete records of the chemicals to diagnose and treat the patient. For instance, in Pennsylvania, the state requires (emphasis added),

“…companies disclose any information sought by a doctor if he or she ‘determines that a medical emergency exists and the specific identity and amount of any chemicals claimed to be a trade secret or confidential proprietary information are necessary for emergency treatment.’ But the law says any information that’s designated as a trade secret or as proprietary will only be turned over with ‘a verbal acknowledgment by the health professional that the information may not be used for purposes other than the health needs asserted and that the health professional shall maintain the information as confidential.’”

In a recent radio interview, Dr. Theodore Them, the Chief of Occupational and Environmental Medicine for Guthrie Health Systems in Bradford County—one of the most heavily drilled areas in the country—said that such instances are exceedingly rare:

“As far as the remainder of the population, in the six or eight years that we’ve been having drilling ongoing around us, I’ve had two people come to me or were referred to me. Two total.

That’s the extent of the people that I have either had referred to me or I have seen in my practice in occupational medicine since 2006-2007-2008. I’m not seeing a flurry of people coming to see us along these lines, despite the fact that the 275 other physicians in my group know that, I and my core colleagues, are the experts in these matters and that such patients should be sent to us. We’re not seeing them.” (18:30-22:18)

Sack Claim #3: “It is also a fact that fracking has been conducted in some 25 U.S. states including Florida (2013), plus in many other countries. Fracking is not regulated in Florida. It is entirely appropriate and necessary for the Florida Medical Association to see that fracking is regulated both responsibly and in a manner that will not prevent responsible oil & gas exploration.”

“Our state peak production was in 1978, but has been on the decline ever since,” said Ed Garrett, administrator of the oil and gas regulatory program at the Florida Department of Environmental Protection. “A few fields were discovered and produced in the 1980s, all relatively small, but they too have declined.”

So, oil and gas is not a new concept for the Florida DEP, but as mentioned in EID’s original post, the state will be updating aspects of these regulations including the way in which companies disclose the chemicals used in their operations. No one is disputing that this is occurring.

Below is Dr. Sack’s email in full:

Ms Jacobs,
The recent blog in Energy In Depth concerning the American Medical Association’s attention to natural gas fracking was sadly misleading. The AMA is well aware of FracFocus & it’s limitations. This is why we adopted our new policy this month recommending the full disclosure of the fracking chemicals and the proper testing of the water we drink. Here are the simple facts, mostly from the EPA study that you cited:
1. 70% of fracking wells hid from FracFocus or other databases at least one chemical used. Why do you think these chemicals were hidden from our citizens? Most people understand that companies are hiding serious toxins that may be hazardous to human health. Physicians need this information to care for their patients.
2. The disclosures on FracFocus are made long after the contamination has occurred, too late to be of much value to physicians or the public. Proper protection of human health requires full disclosure of the names of chemicals before drilling begins so that water supplies can be tested both before and after fracking. This is common sense, not expensive, and is wise. Only a thoughtless or irresponsible industry would not support these simple measures; I know that you & your readers will agree. It is absolutely proper for physicians to draw attention to these facts.
3. It is also a fact that fracking has been conducted in some 25 U.S. states including Florida (2013), plus in many other countries. Fracking is not regulated in Florida. It is entirely appropriate and necessary for the Florida Medical Association to see that fracking is regulated both responsibly and in a manner that will not prevent responsible oil & gas exploration.
Thank you for mentioning My Green Doctor, a free service of the Florida Medical Association & World Medical Association that helps medical offices improve their environmental practices & to teach this to their patients. Much of the content you cited is only informational & not the policy of My Green Doctor or its organizations.
Please send me the web link for your publication of this response to your blog.
Todd L Sack MD FACP

— Original Post June 12, 2015 —

Earlier this week, the American Medical Association (AMA) issued a statement announcing that it had voted during its annual meeting “to adopt new policies on emerging health care topics.” Two specific policies were mentioned in the AMA release: one calling on itself to do more to ensure veterans have access to better health care closer to home (cool); and the other “supporting the full disclosure of chemicals placed into the environment” during the hydraulic fracturing process.

Come again?

If it strikes you as strange that an organization like AMA would select an issue like this to jump into, passing up any number of other matters and phenomena on which it and its members actually have something resembling genuine expertise, you’d be right: it is strange.

But do a little digging around, and what you find is that the folks responsible for drafting the resolution and sneaking it past AMA’s “House of Delegates” actually have a couple things in common. Things like: 1) none of them actually live in states where serious shale development is taking place, and 2) all of them are card-carrying members of separate organizations (on the side) that are committed to preventing oil and gas from being used and produced. Turns out, it’s not really hydraulic fracturing they’re after here – and it certainly isn’t about disclosure of fluids. Nope: it’s just about attacking fossil fuels.

Anyway, we’ll introduce you to the resolution’s backers in a bit. For now, let’s take on the primary contention put forward by the AMA resolution – namely, that “most states do not require drilling companies to publicly disclose what chemicals” are injected during the fracturing process, and that “if companies are going to be responsible petroleum and gas explorers and extractors, they need to disclose the chemicals they use and do better water testing” — which is what Dr. Todd Sack, a Florida-based gastroenterologist who authored the resolution, told the Pittsburgh Post-Gazette.

Thankfully, in a bit of news that is sure to put Dr. Sack’s mind at ease, it turns out that the vast majority of states in which oil and gas development actually takes place already do, in fact, require the disclosure of materials and fluids used in the fracturing process. Let’s run through them all quick for the benefit of the good doctor.

Virtually All Oil-and-Gas States Already Require Disclosure

The following is a map from the national chemical registry database FracFocus that shows which states have a disclosure requirements for the additives used in the hydraulic fracturing process. It’s been around for a couple years now and is updated on a daily basis, which should have left AMA plenty of time to take a look before issuing its statement this week.

As one can see from the map, the majority of states—29, in fact—already require some form of chemical disclosure, with two additional states in the process now of moving legislation. So, in case you’re keeping score at home: right now, today, 29 out of 50 U.S. states have or will soon have robust disclosure rules on the books specific to unconventional oil and gas development and well completion activities.

So what about those other 31? Well, 23 of those states require that companies disclose the chemicals used in the fracturing process via the FracFocus.com platform, where the public can access data on a well-by-well basis, with all additives posted and enumerated for everyone to see (along with concentrations, even). Four more states are in the process now of implementing similar reporting requirements, including Florida and Virginia.

So: of those handful of states that don’t currently have (or are not in the process of developing) new requirements, guess what THOSE all have in common? There’s virtually no oil and gas development taking place in those states. According to the Energy Information Administration (EIA), Oregon’s got about two dozen gas wells knocking around somewhere; Arizona’s got five, and Maryland has seven. So, in other words, there’s actually a pretty good reason why a handful of states don’t have disclosure rules related to hydraulic fracturing on the books. It’s because there’s no hydraulic fracturing going on! Pretty important context to have, right? Thankfully, veteran reporter Don Hopey of the Pittsburgh Post-Gazette made sure his readers weren’t fooled by the “so many states don’t have disclosure rules!” trick, right?

“Most of the 25 states in the U.S. where shale gas drilling and development is occurring — including Pennsylvania, where drilling in the Marcellus and Utica shale formations is booming — either don’t know or don’t publicly disclose all the chemicals used in fracking.”

Oh well. We still love you, Don.

Doctor Strangelove

Earlier in this post, we allude to some of the folks who were responsible for bringing this resolution forward. Again, at first blush, the fact that the AMA would be spending its time and resources on addressing an issue on which a number of far more expert and capable organizations (we can’t believe we’re about to say this, but: “like the EPA”) have already done plenty of study and evaluation is pretty strange, right? But when you take a closer look at the people behind the resolution, the “why” comes into a bit better focus.

Take, for instance, Dr. Sack, the gastroenterologist from Jacksonville, Fla. we mention earlier. True enough, Dr. Sack doesn’t live anywhere near anything that anyone would consider serious oil and gas activity – the closest shale play to him, best we can tell, is all the way out there in Mississippi. But the thing about Dr. Sack is he really doesn’t like fossil fuels – even runs a website called “My Green Doctor” on the side that, among other, actual useful things you can find on it (like reminding folks to change-out their lightbulbs), sometimes betrays a darker side as well. Like this Tweet:

Anyway, there’s nothing wrong with being both 1) a doctor and 2) someone who cares about the environment. We’re one med-school diploma away from being in that same boat right along with him! But Dr. Sack doesn’t just run a kitschy green website – he’s also a member of the Florida Sierra Club and sits on the steering committee of the Florida chapter of Physicians for Social Responsibility (PSR) – groups that want to ban fracking everywhere. Sack’s well-trained bias on these issues comes through pretty clearly in his comments to the Pittsburgh Post Gazette:

“Keeping the names of the chemicals secret is preposterous. The AMA feels that if companies are going to be responsible petroleum and gas explorers and extractors, they need to disclose the chemicals they use and do better water testing. That’s not a radical position.”

With nearly all oil and gas producing states and the federal government requiring public disclosure of the chemicals used in hydraulic fracturing, and with the majority of companies going above and beyond to publicly share information on FracFocus, it’s important to understand what the website is and how easy it is to find information on it.

FracFocus is a national chemical registry used by 23 states and the federal government to make the solutions used in hydraulic fracturing operations publicly available. It was started in 2011 as a voluntary reporting site by the Ground Water Protection Council (GWPC) and the Interstate Oil and Gas Compact Commission (IOGCC). The site was “created to provide the public access to reported chemicals used for hydraulic fracturing within their area” and “to provide factual information concerning hydraulic fracturing and groundwater protection.” In 2012, GWPC wrote a guest post for EID clearing up some of the common myths about the site, which you can view here.

Since its start in 2011, the database has evolved to better meet the needs of viewers looking for information on it and now boasts nearly 100,000 well sites in its registry. Some of the most recent changes include:

Finding information on the site is pretty simple. Click on “Find a Well” and this search will come up:

From there, anyone can search for the well next door or look up all the wells in a given county or state – the possibilities are endless! The registry now even allows users to search for a specific ingredient and view all the wells that used it, a new feature. Once a well is selected, a person can see the “Material Safety Data Sheet” (or MSDS) for the site, which includes the chemicals that were used to hydraulically fracture that particular well. Here’s a sample from the first well listed in Lycoming Co., Pa., where I live:

FracFocus is a user-friendly, easy to search public database. All AMA and Dr. Sack had to do was consult it. If they had, they would have found that the oil and gas industry is already doing everything they apparently believe isn’t being done at all.